Overactive Bladder/Urge Incontinence
Tired of Running to the Bathroom?
That sudden urge to urinate can be frustrating and difficult to control. But it’s treatable.
What is OAB?
Overactive bladder, also called OAB or urge incontinence, causes a frequent and sudden urge to urinate that may be difficult to control. You may feel like you need to pass urine many times during the day and night and may also experience leakage.
What are the symptoms of OAB?
You may experience the following common symptoms:
- A sudden urge to urinate that is difficult to control, running to the bathroom
- Unintentional loss of urine immediately after an urgent need to urinate (urgency incontinence)
- Frequent urination (urinating sooner than every 2 hours)
- Waking up more than two times in the night to urinate (nocturia)
What causes OAB?
Sometimes the cause of overactive bladder is unknown. Some known causes include:
- Abnormalities in the bladder
- Bladder outlet obstruction (i.e., enlarged prostate, urethral scar formation)
- Hormonal changes in women during menopause
- Kidney disease
- Medications (i.e., water pills)
- Caffeine, alcohol, or certain foods (i.e., artificial sweeteners, spicy foods)
- Nerve damage
- Neurological disorders (i.e., Stroke, multiple sclerosis, Parkinson’s disease)
In addition, signals sent from the sacral nerves (at the base of the spine) to the bladder may cause the muscle surrounding the bladder to contract, even if the bladder isn’t full.
How is OAB diagnosed?
It is helpful if you keep a diary for a few days before your doctor visit to record times of urination, the amount of urine, leakage, and foods and beverages consumed.
What to know before your visit MidLantic Urology in Philadelphia and surrounding counties:
- During your visit, your doctor will ask you questions regarding your medical history and will perform an exam with focus on your abdomen and genitalia
Other tests that may be performed during or after your visit
- Urinalysis: This evaluates for any blood in the urine or infection
- Post-void residual: The physician will often ask you to void and then check to make sure you are emptying your bladder.
- Urine flow: The physician may have you urinate in a funnel to assess the speed of your urinary stream.
- Cystoscopy: This is a procedure performed in the office where the physician inserts a small scope into the urethra to assess for any abnormalities
- Urodynamics: This is a test where a small tube is inserted into the urethra and another into the rectum to help measure the pressures in the bladder during urination.
How is OAB treated?
- Behavioral changes: Decreasing caffeine (i.e., coffee, soda, tea) and alcohol intake, avoiding artificial sweeteners (i.e. Splenda, Equal, Sweet n’ Low), and stopping fluid intake 2-3 hours before you go to bed may improve your lower urinary tract symptoms.
- Biofeedback: Patients who have trouble locating their Kegel muscles may benefit from biofeedback. A probe monitors the patient’s squeezing for viewing on a computer screen, effectively teaching her to repeat the exercises at home.
- Timed voiding: Urinating at defined intervals to retrain your bladder
- Avoid constipation
- Pelvic floor physical therapy/Biofeedback: This will help either strengthen or relax the muscles of your pelvic floor, which may be contributing to your urinary symptoms
- Medications: Anti-cholinergics or Beta-agonists: Medical therapy that relax the muscles of the bladder making urination less frequent and urgent. These medications may also improve the number of times you wake up at night to urinate.
- Botox: A minimally invasive procedure where Botox is injected into the muscles of the bladder to improve relaxation and decrease urgency, frequency, and waking up at night to urinate.
- InterStim: This tiny device is implanted to help your nerves function normally by delivering mild electrical pulses. It works much like a pacemaker. During a two-week trial period, your doctor determines if the device is right for you. If so, the device is implanted in your lower back.
- Tibial nerve stimulation: Similar to InterStim, this works to modulate the nerves to the bladder and decrease urgency, frequency, and waking up at night to urinate.